The Five Ways Framework for AI Ethics in Healthcare: Integrating Core Ethical Principles, Blockchain Transparency, Autonomous Agents, Data Governance, and Digital Identity for Patient Privacy and Sovereignty

Artificial intelligence systems in healthcare operate in high-stakes environments where algorithmic decisions directly affect patient outcomes, privacy, and autonomy. This paper introduces the Five Ways Framework, a comprehensive ethical architecture integrating five interconnected pillars: core ethical principles, blockchain transparency, autonomous AI agent oversight, data governance, and self-sovereign digital identity. The framework addresses the critical challenge of protecting patient privacy and sovereignty while enabling the transformative potential of AI-driven healthcare. We validate the framework using the MIMIC-IV dataset, demonstrating measurable improvements in privacy protection (k-anonymity ≥ 5), algorithmic fairness (bias metrics < 0.1), consent compliance (> 95%), and audit trail completeness (100%). Our findings indicate that ethical design strengthens both technical outcomes and stakeholder confidence.